Wound and therapy compress and dressing

ABSTRACT

A dressing for treatment of a body part surface of a human or animal patient. The dressing includes a compress with a plurality of loose fill granules contained in an enclosure. The plurality of loose fill granules is configured to deliver moist heat. The dressing also includes antibacterial medication that is activated by the moist heat delivered from the compress and released toward the body part surface. The fill granules substantially retain at least one antimicrobial metal material therein and allow repeated absorption and dissipation of moisture to and from the fill granules.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. Non-Provisional patent application Ser. No. 13/832,626 filed on Mar. 15, 2013, which is a continuation-in-part of U.S. Non-Provisional patent application Ser. No. 13/291,059 filed Nov. 7, 2011, now U.S. Pat. No. 8,420,882 issued Apr. 16, 2013, which is a continuation of U.S. Non-Provisional patent application Ser. No. 10/380,803, filed May 30, 2003, which is a US. National Phase of International Patent Application Serial No. PCT/US2001/028908, filed on Sep. 17, 2001, which claims priority to and the benefit of the filing date of U.S. Patent Application No. 60/232,826, filed on Sep. 15, 2000, in the United States Patent and Trademark Office, all of which are hereby incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates generally to medical treatment devices and therapeutic methods, and more particularly to moist-heat therapy compresses and wound dressings, and to a wound dressing and/or heat-therapy compress containing antimicrobial metal(s) providing a germ and microbial free environment within the article and treated areas.

BACKGROUND

Modern wound dressings are designed to promote healing by providing a moist, warm or heated, wound environment. Warming a wound promotes healing by increasing blood flow to the area. Moisture in a wound is also very important to the healing process because it helps cells grow and divide, and reduces scarring. Available modem dressings may be dampened or moistened and then heated, for example, by microwave heating. Concurrent with the development of these dressings is the concern regarding a potential for microbial colonization of the wound. Antibiotics are available to combat infections but many people are allergic to certain antibiotics and antibiotic usage can cause gastrointestinal upset or other side effects. Further, excessive use of antibiotics has been blamed for the occurrence of treatment-resistant bacteria.

Moist heat therapy applied by an area compress may also be beneficial to the treatment of arthritic or sprained joints, strained muscles, back pain, rheumatoid arthritis, or in any treatment where heat might be applied through or to the skin to promote circulation therein and thereunder. In such applications where no wound exudates contaminate therapy materials, reusability of the compress is an attractive cost-efficient design feature. Bacterial presence can cause dermatological problems to the treated area and further, a growing microbial colony in a reusable compress can cause the spread of infection through cross-contamination when handled. This may represent a particular threat to therapy patients, many of whom have persistent or slow-healing injuries or compromised immunity systems.

A growing strategy for reducing the potential for infection or bacterial growth in a wound or on skin tissue under moist heat therapy is the incorporation of noble metal antimicrobials into the therapeutic wound dressing. The most prevalent such metal in use is silver due to its relative lack of cytotoxic effects and wide spectrum of antimicrobial effectiveness. Medical materials and instruments are available which provide the emission of silver metal or silver compounds to provide an antimicrobial effect. Such available dressings, once moistened, release silver into the surrounding liquid. The dressing thereby becomes an effective antimicrobial barrier. The silver, however, is consumed and lost in the process. Such products are inherently not conveniently reusable.

In both moist heat therapy wound dressings and compresses, bacterial and fungal growth can also cause unpleasant odor and unsightly discoloration which may adversely affect the morale of the patient. Thus there is a need in general for dressings and compresses designed to maintain sterility therein and to also provide microbial free moisture.

SUMMARY

In example embodiments, the present invention provides a wound dressing and/or therapy compress having a granular fill material permanently loaded with at least one antimicrobial agent. The at least one antimicrobial agent comprises a form of silver, which form of silver may comprise atomic silver or a composition of silver. The dressing or compress thus comprises a fluid permeable shell and a backing, each of which is attached to the other to define a plurality of fill enclosures therebetween, and a fill material enclosed within the respective enclosures. A fluid permeable outer cover may be provided to protect the dressing or compress. The dressing may be used to shelter and protect a wound while absorbing exudate, and may also provide and maintain a heated and/or moist environment to promote the healing of the wound. The compress may be used to deliver moist heat therapy to an arthritic or sprained joint or strained muscle area.

In other aspects, example embodiments of the invention relate to a wound dressing and/or therapy compress having a granular fill material such as a hydrophilic zeolite or molecular sieve material, optionally loaded with at least one metallic antimicrobial agent, such as for example a silver, copper, copper oxide, gold, magnesium oxide, aluminum oxide, titanium dioxide, zinc oxide, cobalt, nickel, zirconium, molybdenum, tin, lead and/or other metals, metal oxides, metal ions, metal particles or nanoparticles, and alloys, mixtures or combinations thereof. The dressing or compress preferably comprises a flexible and body part conformable treatment device having a fluid-permeable shell and a backing, each of which is attached to the other to define at least one, and preferably a plurality of fill enclosures therein, and a particulate fill material enclosed and loosely contained within the respective enclosure(s). A fluid-permeable removable and replaceable outer cover may optionally be provided to protect the dressing or compress.

The fill material may be prepared wet or moistened, or desiccated to dryness to either deliver or absorb moisture as appropriate to the desired treatment. The fill material absorbs or delivers this moisture through the lower shell. The shell is formed to be fluid-permeable, i.e., vapor-permeable and liquid-permeable, and is adapted to be placed in contact with a wound or tissue directly or through a vapor-permeable and liquid-permeable outer cover. The backing may also be fluid-permeable, or non-permeable if so desired, so as to allow for the release or retention of moisture as appropriate to the desired treatment.

The shell and backing are joined to form at least one, and preferably a plurality of enclosures there between. The enclosures may contain the loaded fill material. The presence of the antimicrobial agent within all or some of the fill material promotes a germ and microbial free environment at and near the lower shell and within the dressing or compress. The device and its constituent components are preferably water resistant and microwave safe, whereby the device can safely be subjected to repeated cycles of wetting, microwave heating and cooling, without significant deterioration or loss of its moist heat therapy, antimicrobial or antibacterial characteristics. The dressing or compress may be washable and reusable.

In a first example, the invention relates to dressing for treatment of a body part surface of a human or animal patient. The dressing includes a compress with a plurality of loose fill granules contained in an enclosure. The plurality of loose fill granules is configured to deliver moist heat. The dressing also includes antibacterial medication that is activated by the moist heat delivered from the compress and released toward the body part surface. The fill granules substantially retain at least one antimicrobial metal material therein and allow repeated absorption and dissipation of moisture to and from the fill granules.

In another example, the invention relates to dressing for treatment of a body part surface of a human or animal patient. The dressing includes a moist-heat-delivery compress with a plurality of loose fill granules contained in an enclosure. The plurality of loose fill granules includes at least one of a group comprising zeolites, alumina, silica, bentonite and molecular sieves. The dressing also includes a heat transmissive pad impregnated with antibacterial medication that is unidirectionally released toward the body part surface. The antimicrobial medication is activated by the moist heat delivered from the compress.

In still another example, the invention relates to a method for delivering antibacterial medication to a skin surface. The method includes engaging a heat-transmissive pad with the skin surface. The heat transmissive pad is impregnated with an antibacterial medication. The method also includes activating the antibacterial medication with moist heat from a compress. The compress includes a plurality of moist-heat-retaining loose fill granules contained in an enclosure.

These and other aspects, features and advantages of the invention will be understood with reference to the drawing figures and detailed description herein, and will be realized by means of the various elements and combinations particularly pointed out in the appended claims. It is to be understood that both the foregoing general description and the following brief description of the drawings and detailed description of the invention are exemplary and explanatory of preferred embodiments of the invention, and are not restrictive of the invention, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partial side cross-sectional view of a dressing or compress according to an example embodiment of the present invention.

FIG. 2 is partial plan view of an exemplary hexagonal enclosure pattern according to an example embodiment of the present invention.

FIG. 3 is a plan view of an alternate exemplary dressing or compress with a hexagonal enclosure pattern.

FIG. 4 is a plan view of a wrap compress with ties using the dressing or compress of the present invention.

FIG. 5 is a plan view of a moist heat therapy compress in the form of an eye or nasal/sinus compress according to another example embodiment of the present invention.

FIG. 6 is an exploded side view of a moist heat therapy compress of either FIG. 1 or FIG. 5 in use with an antibacterial wipe placed on an eye.

DETAILED DESCRIPTION OF EXAMPLE EMBODIMENTS

The present invention may be understood more readily by reference to the following detailed description of the invention taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this invention is not limited to the specific devices, methods, conditions or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed invention. Any and all patents and other publications identified in this specification are incorporated by reference as though fully set forth herein.

Also, as used in the specification including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and reference to a particular numerical value includes at least that particular value, unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” or “approximately” one particular value and/or to “about” or “approximately” another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment.

Referring now to FIGS. 1-4, and as best illustrated in FIG. 1, a dressing or compress 100 is illustrated having a lower shell 102 and a flexible upper backing 104 which are joined or otherwise fastened to one another to form a series of enclosures 106 there between. The enclosures are provided for the containment and relatively uniform distribution of a plurality of fill granules 108 placed therein. The enclosures may be fashioned as filled pods which are draped from the backing. The shell 102 forms the contact surface of the dressing or compress used to drape or form the bottom of the filled enclosures which are to be placed against the tissue to be treated, and to conform to the shape of the treatment area. The backing forms the smoother outer surface of the dressing or compress facing away from the treatment area.

The enclosures 106 may be defined as hexagons using patterned seams 110 for local symmetry and efficient regular plane division. An illustrative hexagonal pattern 200 of enclosures 202 is illustrated in FIG. 2. The enclosures might also be fashioned as circles, octagons, or of any desired shape as may be appropriated for the desired treatment. The enclosures may be selectively sized as appropriate to the application. Each hexagonal shaped enclosure 202 has a lengthwise dimension 204 extending from a first corner to an opposite second corner thereof. For example, and not by way of limitation, this dimension may be in the range of from approximately one inch to approximately four inches in length. Large treatment areas such as the human torso or appendages may best be served with enclosures having a dimension 204 extending lengthwise for approximately 4 inches. Highly contoured areas such as the face may best be served with enclosures having a dimension 204 of approximately 1 inch in length.

An alternate dressing or compress 300 is illustrated in FIG. 3, having a plurality of hexagonal patterned enclosures 302. Each of the enclosures may also be formed as a channel-like rectangle, as illustrated in FIG. 4. The embodiment of the dressing or compress 400 is formed to have several channel enclosures 402 formed within a wrap compress having securing ties 404. So constructed, the dressing or compress 400 may be provided for the treatment of soreness or strains of the human back. In alternative applications, for example as illustrated in FIG. 5, the dressing or compress 500 is adapted for use as an eye compress for application of moist heat therapy to a subject's eyes with enclosures 502 for containing the fill granules and securing ties 504 for attachment around a patient's head, such as for treatment of dry-eye or other eye conditions; for moist heat therapy to a subject's sinus or nasal areas; and/or for treatment of other body parts of a human or animal subject or patient for wound care, epitheliazation, antibacterial, antimicrobial, antiviral, antifungal, anti-inflammatory, analgesic, moist heat therapy and/or other treatment purposes. In the eye compress configuration shown in FIG. 5, the flexible outer shell includes a generally triangular or trapezoidal nose cut-out area 506 at a medial portion of its lower edge, between first and second lobes 508 a, 508 b for covering areas over and around the user's left and right eyes when in use, with the ties or an elastic strap placed around the user's head, typically over the ears, to retain the compress 500 in place.

An alternative system is described in FIG. 6, whereby a heat compress 600 is combined with a heat transmissive pad or lid scrub or wipe 604 and is applied onto a skin surface 604, for example an eyelid. The pad or wipe 604 is preferably constructed of non-woven material and alternatively, material that can be RF or thermally sealed to hold an antibacterial medication. The example pad or wipe 604 can have a construction that is impregnated with antibacterial medication and can be effective in either a moist or dry condition. The antibacterial medication can include material, for example liposomes and/or microspheres. The pad or lid scrub or wipe 604 can be removably secured to the compress 600 for single use or multiple use. Alternatively, the antibacterial medication can be permanently incorporated into the compress 600, for example by permanently attaching the pad or lid scrub or wipe 604 to the compress or impregnating the medication into the compress directly, for single use or multiple use.

The example pad or wipe 604 is constructed to be moist-heat transmissive so that an application of moist-heat activates the release of the impregnated antibacterial medication onto the skin surface 606. The example pad or wipe 604 is constructed to prevent the impregnated antibacterial medication from passing back into the compress 600 during application. A one-way-valve or sheet barrier 602, disposable or semi-disposable, can be placed between the pad or wipe 604 and the compress 600 to prevent any antibacterial medication from the wipe from entering the compress. This one-way-valve 602 can be secured to the compress 600 with hook-and-loop or equivalent means.

The example pad or wipe 604 can have a round or oval disk shape with appropriate size and shape to be placed over a single eyelid. The disk 604 can be constructed of non-woven material. In use, two disks can be used, one over each eye. A plurality of the disk 604 can be stored within a jar containing antibacterial medication fluid, so as to pre-moisten the wipes during storage. In use, a pair of disks 604 are removed from the jar and one is placed over each eye of a user while the user is lying down. An appropriately-sized rectangular or mask-shaped layer of the non-woven one-way-valve barrier 602 is then placed over the disks 604 set on the eyes. The compress 600 can then be placed over the one-way-valve 602 for the desired treatment duration. Once treatment is completed, each disk 604 can be used to wipe the eyelid on which it was placed.

Alternatively, the disk 604 can be stored in a dry state with an integrated one-way-valve layer 602 covering one side. Once removed from packaging, the dry disk wipe 602 is applied with an appropriate volume of antibacterial treatment fluid on a side opposite the one-way-valve layer 602 and then used in a similar manner as described previously.

Alternatively, the disks 604 can be packaged in a single-use pair or can be cut out from a pore-gradient fabric before use.

The compress 600 can, for example, have a construction similar to the compress 100 in FIG. 1, or the compress 500 in FIG. 5 or an alternative design. In use with compress designs 100, 500, the pad or wipe 604 can secure to the compress through hook-and-loop or sewing for multiple use. Alternatively still, the pad or wipe 604 can be constructed as an independent single-use sheet and is discarded after application. The compress 600 can alternatively be constructed as an independent sheet for multiple uses.

During use on a skin surface 606 affected with a condition, for example blepharitis in an eyelid, the application of moist heat from the compress 600 will expand the pores on the skin surface. When the pores are expanded, the transdermal passage and effectiveness of the antibacterial medication from the pad or wipe 604 through the skin is increased.

The size of the enclosures and overall dressing are selected to serve the desired treatment. Selected single sites for treatment such as the eye may best be treated using a single enclosure dressing or compress appropriately sized and shaped to rest comfortably in the eye hollow of the human face. The dressing or compress may be shaped as a regular or irregular polygon, any smooth closed curve, or any closed combination of line segments and smooth curves. The invention is not limited to constructions conforming to or only serving the human body. The invention provides a potentially useful treatment for the ailments of mammals and any animals benefiting from the healing properties of moisture and/or heat therapy.

A fluid-permeable, i.e., a vapor-permeable and/or a liquid-permeable protective outer cover (not illustrated) may be provided to encompass the compress. This may be preferable to limit contamination of the dressing or compress. For the treatment of open wounds, an uncovered disposable dressing (not illustrated) may be preferred for optimal formable contact with, and healing of, the exposed tissues. Alternatively, the cover and other materials of the compress or dressing are washable for repeated re-use.

The fill contained within the enclosure or enclosures may comprise a synthetic porous crystalline granular aluminosilicate zeolite, commonly used as a molecular sieve material, or other substances with similar properties. The fill material may further comprise other inert additives and physical matrices without affecting the antimicrobial and hydrous efficacies of the fill. Optionally, the wound dressing and/or therapy compress comprises a granular fill material such as activated alumina, silica gel, bentonite or hydrophilic zeolite or molecular sieve material, with at least one metallic antimicrobial agent, such as for example a silver, copper, copper oxide, gold, magnesium oxide, aluminum oxide, titanium dioxide, zinc oxide, cobalt, nickel, zirconium, molybdenum, tin, lead and/or other metals, metal oxides, metal ions, metal particles or nanoparticles, and alloys, mixtures or combinations thereof deposited therein. For example, silver or other metal loading of the fill may be attained by the process of ion-exchange, as known. In this process, a solution containing atomic silver or a composition of silver bathes, or is passed through, a bed of the fill granules 108 (FIG. 1). An ion-exchange column method, as known in the art, may be performed in which an aqueous solution containing atomic silver or a composition of silver may be passed through a column bed of the fill granules, and the eluted solution may again be passed through the bed or may receive additional silver and then be again passed through the bed.

Various ion-exchange schedules known in the art may be applied to produce retention of the silver or other metals. For example, the final content by weight of the atomic silver or silver composition may be as high as twenty percent of the final loaded fill granules. The loaded fill granules produced by ion-exchange will exhibit high retention of the silver or other metals even under subsequent exposure to fluids and microwave irradiation. The fill granules may comprise a blend of both loaded and unloaded zeolite or a substance retaining silver or other metals. The presence of the atomic silver or other metals will not interfere with the useful properties of the fill granules such as the moisture desorption and adsorption properties which may be desirable in the use of the dressing or compress. The inherent hydrophilic nature of the zeolite provides that a substantial water content is available therein by absorption from the atmosphere. The water so absorbed may be sufficient, or may be supplemented by manually added water, for providing the microwave responsive water content of the dressing or compress. The compositions of silver or other metals used may include but are not limited to, metal compounds, and metal salts such as silver chloride and silver nitrate.

The presence of the silver or other metals within the fill granules contained in the enclosure of the invention provides anti-microbial properties to the dressing or compress. The ion-exchange loaded fill granules will retain the silver or other metals despite microwave heating as may be required in the use of the dressing or compress, which prevents the release of silver or other metals into a treated wound if the invention is used as a dressing. Further, the retention of the silver or other metals within the fill granules provides assured antimicrobial performance in a reusable and potentially washable, if so desired, moist heat therapy compress.

The compress or dressing of the present invention(s) alternatively comprises fill granules such as a hydrophilic zeolite with or without anti-microbial metal(s) disposed therein. Example anti-microbial metal(s) include adsorbent technologies employing beads of activated alumina, silica gel, bentonite and molecular sieves, with or without metals. For wound dressing applications, the provision of anti-microbial metal(s) may be preferable. For therapeutic compress applications, the provision of anti-microbial metal(s) is optional. Moist heat therapy applied by an area compress may be beneficial to the treatment of arthritic or sprained joints, strained muscles, back pain, rheumatoid arthritis, or in any treatment where heat might be applied through or to the skin of a human or animal patient or subject, to promote circulation therein and there under. In such applications where no wound exudates contaminate (imbedded metals may not be incorporated into the molecular sieve granules when used for this purpose), reusability and ability to wash the compress are attractive cost-efficient design features. Thus, example embodiments of the invention comprise a washable and/or reusable compress.

In the described embodiments of the invention, the lower shell and the upper backing are each constructed of materials known in the art. Each may therefore be comprised of multilayered laminates, for example, with pore sizes selectable to meet the moisture transmission and retention properties desired for the specific treatment sought. The dressing or compress is adapted to be placed and to remain in intimate contact with the area to be treated to maintain a heated and/or moist environment thereabout. Dressing or compress constructions using woven textiles of natural fibers have been found to have limited spatial conformance to the various shapes, dimples, wrinkles and joints offered by the human body, although these materials may be used if so desired.

Accordingly, preferred dressing or compress constructions will use formable woven and non-woven synthetic materials or combinations thereof which may include, but are not limited to, synthetic olefin, polyester, urethane, and nylon. The shell and the backing may be fastened together across the area of the dressing or compress with a fill material, the fill granules 108, received there between. The shell and the backing may be fastened to one another by methods which may include, but are not limited to, adhesive attachment, RF welding, ultra-sonic attachment, sewing, or patterned heat application using a template or forming die to form a seal. To provide for the secure placement of the dressing or compress, peripheral or attachment fastening devices may be included which may comprise the desired number of Velcro®-type fasteners, adhesives, high tactility polymer materials, and/or material ties.

Throughout the construction of the dressing or compress, attention and care is taken in the selection of materials regarding thermal response to microwave heating. For design simplicity, all synthetic, microwave non-responsive materials may be selected to provide that the fill and/or water content of a moistened dressing or compress provide the only substantial thermal response to microwave irradiation.

Although several embodiments of the invention have been disclosed in the foregoing specification, it is understood by those skilled in the art that many modifications and other embodiments of the invention will come to mind to which the invention pertains, having the benefit of the teaching presented in the foregoing description and associated drawings. It is thus understood that the invention is not limited to the specific embodiments disclosed hereinabove, and that many modifications and other embodiments are intended to be included within the scope of the invention. Moreover, although specific terms are employed herein, they are used only in a generic and descriptive sense, and not for the purposes of limiting the described invention. The words “a,” “an,” or “the” can mean one or more, depending upon the context in which the words are used hereinabove. 

What is claimed is:
 1. A dressing for treatment of a body part surface of a human or animal patient, the dressing comprising: a compress comprising a plurality of loose fill granules contained in an enclosure within the compress, the plurality of loose fill granules configured to deliver moist heat; a heat transmissive pad impregnated with an antibacterial medication, attached to a surface of the compress such that the heat transmissive pad is positioned between the compress and the body part surface, wherein the heat transmissive pad is activated by the moist heat delivered from the compress to release the antibacterial medication from the heat transmissive pad onto the body part surface; and wherein the fill granules substantially retain at least one antimicrobial metal material therein and allow repeated absorption and dissipation of moisture to and from the fill granules.
 2. The dressing of claim 1, wherein the antibacterial medication comprises liposomes.
 3. The dressing of claim 1, wherein the antibacterial medication comprises microspheres.
 4. The dressing of claim 1, wherein the plurality of loose fill granules comprises zeolites.
 5. The dressing of claim 1, wherein the plurality of loose fill granules comprises at least one of a group comprising activated alumina, silica gel, bentonite and molecular sieves.
 6. The dressing of claim 5, wherein the plurality of loose fill granules have a beaded construction.
 7. The dressing of claim 1, wherein the heat transmissive pad is permanently secured to the compress.
 8. The dressing of claim 1, wherein the heat transmissive pad is removably secured to the compress.
 9. The dressing of claim 1, wherein the compress comprises a shape that is configured to cover an eyelid surface.
 10. A dressing for treatment of a body part surface of a human or animal patient, the dressing comprising: a moist-heat-delivery compress comprising a plurality of loose fill granules contained in an enclosure within the compress, the plurality of loose fill granules comprising at least one of a group comprising zeolites, alumina, silica, bentonite and molecular sieves; and a heat transmissive pad, attached to the outside of the moist-heat-delivery compress such that the heat transmissive pad is held between the compress and the body part surface, the heat transmissive pad being impregnated with an antibacterial medication that is unidirectionally released onto the body part surface, wherein the antimicrobial medication is activated by the moist heat delivered from the compress.
 11. The dressing of claim 10, wherein the fill granules substantially retain at least one antimicrobial metal material therein and allow repeated absorption and dissipation of moisture to and from the fill granules.
 12. The dressing of claim 10, wherein the antibacterial medication comprises liposomes.
 13. The dressing of claim 10, wherein the heat transmissive pad is removably secured to the compress.
 14. The dressing of claim 10, wherein the wherein the heat transmissive pad is permanently secured to the compress.
 15. The dressing of claim 10, wherein the compress and the heat transmissive pad each comprise a shape that is configured to resemble an eyelid surface.
 16. The dressing of claim 10, wherein the antibacterial medication comprises microspheres.
 17. The dressing of claim 1, further comprising a sheet barrier placed between the compress and the heat transmissive pad that prevents antibacterial medication from entering the compress.
 18. The dressing of claim 10, further comprising a one-way barrier placed between the compress and the heat transmissive pad that prevents antibacterial medication from entering the compress.
 19. A dressing for treatment of a body part surface of a human or animal patient, the dressing comprising: a compress comprising a plurality of loose fill granules contained in an enclosure within the compress, the plurality of loose fill granules configured to deliver moist heat; and a barrier sheet secured to an outside surface of the compress; and a heat transmissive pad attached to the compress such that the barrier sheet is positioned between the compress and the heat transmissive pad and wherein the heat transmissive pad is impregnated with an antibacterial medication that is activated by the moist heat delivered from the compress and released onto the body part surface; and wherein the barrier sheet prevents antibacterial medication released from the heat transmissive pad from entering the compress.
 20. The dressing of claim 19, wherein the antibacterial medication comprises at least one of liposomes and microspheres. 